Cutaneous Lesions in Brucellosis

Two types of eruptions developed in a patient who had a fever of unknown origin: (1) tiny papules on the trunk and proximal extremities and (2) erythema nodosum-like deep dermal nodules on the legs. Brucella agglutinin test results were persistently negative, but B melitensis grew from the blood culture. Brucellosis should be considered in the differential diagnosis of a fever of unknown origin associated with a papular eruption with certain histologic features and/or erythema nodosum-like lesions. The histologic examination of cutaneous lesions may facilitate the diagnosis.